Changes in Pain and Psychosocial Functioning and Transition to Chronic Pain in Pediatric Sickle Cell Disease: A Cohort Follow-up Study.

OBJECTIVES: This study aimed to: (1) examine changes in pain, psychosocial functioning, and healthcare utilization among children and adolescents with sickle cell disease (SCD) over a 2-year period; and (2) identify baseline biopsychosocial variables associated with the development and maintenance of chronic SCD pain at follow-up. METHOD: Forty-two youth (8-1850% shaded blocky old) with SCD completed a battery of self-report measures at baseline and 2-year follow-up. Analgesic, Anesthetic, and Addiction Clinical Trial Translational Innovations Opportunities and Networks and American Pain Society Pain Taxonomy (AAPT) diagnostic criteria were used to categorize patients into pain frequency groups at both time points: chronic (pain on most [>/=15] days/month for the past 6 months, per AAPT diagnostic criteria), episodic (pain on 1-1450% shaded blockd/mo), or asymptomatic (050% shaded blockd/mo). RESULTS: At baseline, 31% (n=13) had chronic pain, 50% (n=21) episodic pain, and 19% (n=8) asymptomatic. At follow-up, 40.5% (n=17) had chronic pain, 52.4% (n=22) episodic pain, and 7.1% (n=3) asymptomatic. Between baseline and 2-year follow-up, 12% (n=5) developed chronic SCD pain. Depressive symptoms and admissions for pain significantly increased over time for youth with chronic pain (P's<0.05). An interaction effect revealed that baseline pain groups differed in their change in pain intensity over time (P<0.01). Baseline psychosocial factors (i.e., higher functional disability, greater depressive symptoms, higher pain catastrophizing, and lower quality of life) were significantly associated with chronic pain at follow-up. DISCUSSION: Biopsychosocial factors may be associated with the development and maintenance of chronic SCD pain and their relative contributions warrant further study.